Case Study

Summary

As much as $140 billion in government benefits goes unclaimed every year, in part due to the bureaucratic hoops, or administrative burdens, people must jump through in order to obtain public benefits. The Biden-Harris administration is seeking to close this gap in the “Executive Order on Transforming Federal Customer Experience and Service Delivery to Rebuild Trust in Government.” The Facing a Financial Shock Life Experience project, born out of the executive order, focuses on connecting people experiencing financial distress to available public services. Two of the project’s collaborating agencies — the U.S. Department of Health & Human Services’ (HHS) Centers for Medicare & Medicaid Services (CMS) and the Office of Management and Budget’s (OMB) United States Digital Service (USDS) — are partnering with Nava on a project aimed at increasing access to programs like Medicaid and the Supplemental Nutrition Assistance Program (SNAP) by streamlining the income verification process.

Approach

When people apply for certain public benefits, the agency administering benefits must verify the applicant’s income eligibility. Often, federal benefit programs have difficulty verifying an applicants’ eligibility due to a confluence of factors such as change of address, old or out-of-date income data or lack of income data, or lack of paystubs due to self employment or cash payment. In these scenarios, applicants must manually verify their income for eligibility — a process that can be stressful and time consuming.

Our shared work focuses on alleviating the burden of manual verification of income by enabling agencies to verify applicant income through existing data sources. This idea is called Income Verification as a Service (IVaaS). Nava’s history with the idea of IVaaS goes back to 2016, when we worked with CMS on HealthCare.gov’s income eligibility determination services. 

For our current project, we’ve partnered with CMS and USDS to research, prototype, and pilot income verification products that help people facing a financial shock. 

Through this work, we aim to: 

• Reduce the time it takes for applicants to verify their income.

• Alleviate administrative burden for frontline staff and applicants by using automated processes to enable cross-enrollment.

• Reduce the amount of time it takes for applicants to receive benefits.

• Improve the efficiency, accuracy, and integrity of federal benefit programs. 

In order to ensure our work is human-centered, we’ve established a participatory design group of frontline workers, IT staff, and subject matter experts. This group helps us gather feedback and input on our work from those who deeply understand the public benefits space. In addition, we’re conducting interviews with beneficiaries, frontline staff, and organizations that assist people with applying for benefits. We’ve also established a pilot group of agency leaders, which gives us the opportunity to get feedback on our pilots.

Outcomes

Leveraging what we learned from our participatory design practice, we created a plain-language playbook that states can use to simplify content around income verification. We’re using the playbook’s principles to inform our approach to other income verification initiatives, such as our pilot for a consent-based income verification solution that gives applicants the option to automatically share their payroll data with benefit programs. We’re also working on a solution that connects states to the right data sources at the right time so that the onus to provide income data is not on applicants. 

Process

Creating a plain-language playbook

Navigating program rules for eligibility is difficult even for seasoned caseworkers. That’s why we believe that plain-language guidelines on program rules might help people apply for benefits correctly and ease the burden of income verification. 

Based on our early research, we developed a plain-language playbook for income verification. To ensure the playbook is accurate and useful, we tested its content and principles with SNAP recipients, since SNAP has particularly complicated income requirements.  

Now, we’re applying the playbook’s principles to a state’s content on Medicaid income verification. As we pilot the playbook, we’re collecting customer experience metrics, such as the number of times people submit insufficient documentation, to determine whether these content changes can help people understand income verification requirements.  

Piloting consent-based income verification

In the financial services sector, there are many ways to automatically verify one’s income information by giving direct consent to banks or lenders to pull income data from financial institutions or payroll companies. We hypothesized that a similar solution could be beneficial in public benefits, though it’s not in use today. 

To better understand solutions that exist in the private sector, we conducted market research. For example, we explored how mortgage loan applicants can automatically share their income information with a requester. Simultaneously, we conducted user research with SNAP and Medicaid leaders, caseworkers, and applicants to better understand how this type of solution could apply to public benefits. 

Now, we’re piloting this idea with states. We’ve built a prototype that enables applicants to consent to sharing their income data automatically. Our prototype is helping us understand:

• How this new data source fills gaps in automated verification processes, thus covering more applicants. 

• How applicants feel about consent-based income verification. Do applicants trust it enough to use it?

• Whether consent-based income verification provides more accurate income data for eligibility decision making. Can more accurate income data lead to a decrease in improper payments?

• Whether moving from manual to automated verification processes decreases administrative burden for applicants.

Connecting states with the best data sources

Ideally, applicants should only have to provide income information the state doesn’t already have. Though several databases of income information exist, the challenge is helping states connect with the right ones at the right time. 

Government agencies can draw from different data sources when verifying an applicant’s income, and different data sources have pros and cons. For example, private data sources tend to be more current, but they’re expensive to use and are not always comprehensive. On the other hand, government data sources are cheaper and more comprehensive, but may contain data that is not current enough for income verification. 

Agencies may tap each of their data sources at once, or they may tap data sources in a non-optimal order. In other words, one data source may contain the most relevant data for an applicant’s situation, but the challenge is connecting an agency to that data source first. 

We believe that connecting states with the right income data sources in an optimized order could drive down costs because states will only pay for the data they need, and it could save applicants the time spent on manually verifying their information.

We partnered with a state’s Medicaid agency to test this idea. To start, we met with state Medicaid leaders and technical subject matter experts to better understand Medicaid income verification in their state. We also analyzed how and when the state utilizes different data sources for income verification. Based on our research and analysis, we’ve made recommendations for how the state agency can optimize the way they call data sources. Once we’ve tested these recommendations, we hope other states will restructure their data logic in a way that reduces administrative burden on applicants and drives down the cost of data for states. 

Conclusion

The Facing a Financial Shock Life Experience project is an important initiative aimed at reducing administrative burdens for people attempting to access government programs while experiencing financial distress. Through our partnership with CMS and USDS, we’re exploring how we can ease the burden of income verification, helping to increase access to essential benefits.